For middle class groups in the Victorian period, disease and death were common fears. In nineteenth-century Britain, there was a wave of epidemics which affected different parts of society, from the working poor to the urban rich. Undoubtedly, disease and death were mainly caused by the poor housing infrastructure. Combating these issues of disease was therefore important for the middle classes as they feared that the spread of disease would start to affect their way of life. This resulted in different medical societies being formed which were both philanthropic and non-state organisations. Their aims were to tackle sanitary problems that were being faced. Mostly, there were local societies focusing on their particular location based on where they were founded.
The London Epidemiological Society
In London, the Epidemiological Society was formed by individuals who were graduates of science and practiced it through professions such as medical officers and doctors. After several decades, it became successful in providing services for communities who were greatly affected by the poor housing structures which resulted in these diseases to spread. This was possible mainly due to that the society was made up by individuals who understood how to manipulate the ways of science and use it for the benefit of social reform. Equally, the methods that were used were considered enlightened and critical. Numerous statistics provided their justification to show their methods of science were working, communities were living longer and deaths were being prevented. This was shown in the ‘Half a Century of Sanitary progress, and its Results’, an address made by the then president, Henry Franklin Parsons, on the progress of improving sanitary standards.
‘In England and Wales, during the five years 1838-42, the average death-rate per 1,000 inhabitants was 22.1, of which 1.053, or 4 per cent., was due to ” fever” ; and in the four years 1847-50, out of an average annual death-rate of 23.4 per 1,000 inhabitants, 1.246, or 5.3 per cent, was due to fever. On the other hand, in the five years ending 1896, of an average annual death-rate reduced to 18.1 per 1,000 inhabitants, little more than 1 per cent. (.184) has been caused by the several forms of continued fever. In London the death-rate from “fever” per 1,000 inhabitants was 1.339 in the three years 1838-40, and .979 in the ten years 1841-50; whereas in the five years ending 1896 it had fallen to .142.’
This demonstrates that these societies relied heavily on these forms of evidence because of the way it effectively conveyed forms of progress. The methods of science were starting to gain popularity in the Victorian period as people started to find it more knowledgeable and convincing to answer problems and issues that societies were facing. Despite the fact that science was influencing more societies, however, people regarded religion as another important cure to societies problems. Often, science and religion would combine together to justify reasoning towards the sanitary changes. As argued by Heyck, science was not only the body of knowledge and enlightened reasoning, but contributed to moral and ethical issues. Disease and poverty were often referred to as ‘evil’ and ‘foul’. In particular Henry Franklin Parsons was very critical about spread of disease, and his address using religious language and imagery.
‘Nor were these evils confined to the towns, for, as the Commissioners say, “The most important evils affecting the public health throughout England and Wales are characterised by little variety, and it is only in the degree of their intensity that the towns exhibit the worst examples of such evils. Villages and clusters of houses inhabited by the poor are often under the influence of the same causes of disease, though their effect in such situations may be frequently rendered comparatively slight from the more free circulation of the external air.’ 
Therefore, some individuals from these medical societies who focused on medical progression justified the methods of science to help improve sanitary conditions due to their religious convictions and belief. In particular through the ‘sanitary progress’ of the London Epidemiological society, they acted as they were carrying out the work of God.
Other Societies, The State and The Poor
Other societies and individuals attempted to reform sanitary regulations and encouraged others to provide more support for changing the infrastructure of cities. Edwin Chadwick, a prominent social reformer , traveled the country to places such as Brighton to demonstrate how widespread the problems were. 
However, what the report does is not reflect are the opinions of the urban poor in London. Often the urban poor would be skeptical of organisations for meddling with personal affairs and the urban poor were not consulted about the form that infrastructure would take. This would be logical since the urban poor largely made up the inhabitants of the slum and therefore would have more experience with the problems of living in the conditions. Science had only just started to become more popular in this period, and there individuals who would discredit the methods. In addition, Charles Keeley’s ‘Living Off the Slum’ article on this site clearly demonstrates that not all urban communities were happy with the objectives of these medical societies. Part of the ‘dust and dirt’ was of the working class culture, and it was part of their identity as a class.
Parsons’ address does not illustrate also how state actors were intervening with the situation at hand. In particular, there were reasonable efforts made to tackle the conditions of poor infrastructure, particularly through reshaping the sewage systems of towns and to eliminate disease even further. What is even more interesting is the fact the government found uses of getting rid of the ‘manure’ of towns by recycling it for other purposes. This would therefore indicate that some organisations were more efficient than others in making use of the situation by not only improving infrastructure, but making use of the ‘dust and dirt’.
Henceforth, it is difficult to give an overall view about the national scale of the problem due to the fact that the society was based in London. Although the capital city faced considerable housing problems as well as vast progress, it i difficult to find evidence suggesting that this progress stretched outside of London in Henry Parsons’ speech. These types of sources tend to focus on a more local rather than national scale to demonstrate the progress being made by these groups. However, the contents of the address are useful to find what the objectives of the group were and how they tackled these issues over the course of several decades. It is clear there were efforts made to ensure that the sanitary conditions of London would progressively improve with the help of medical societies.
 Henry Franklin Parsons, ‘Half a century of sanitary progress, and its results’, LSE Selected Pamphlets, 1899, p.2-4
 Ralph R Frerichs, ‘London Epidemiological Society’, http://www.ph.ucla.edu/epi/snow/LESociety.html, Date accessed 28/11/2015
 Parsons, ‘Half a century of sanitary progress, and its results’, p.2
 Parsons, ‘Half a century of sanitary progress, and its results’, pp.4-5
 T.W Heyck, The Transformation of Intellectual Life in Victorian England, (Chicago: Lyceum Books, 1982), pp.81-82.
 T.W Heyck, The Transformation of Intellectual Life in Victorian England, p.84
 Henry Franklin Parsons (1846–1913)., 8 November (1913), BMJ 1263. Available online: http://krauthammerlab.med.yale.edu/imagefinder/Figure.external?sp=SPMC3483746%2FS0025727312000294_fig3&state:Figure=BrO0ABXcRAAAAAQAACmRvY3VtZW50SWRzcgARamF2YS5sYW5nLkludGVnZXIS4qCk94GHOAIAAUkABXZhbHVleHIAEGphdmEubGFuZy5OdW1iZXKGrJUdC5TgiwIAAHhwABaU4Q%3D%3D. Date accessed: 09/12/2015
 Parsons, ‘Half a century of sanitary progress, and its results’, p.4
 Parsons, ‘Half a century of sanitary progress, and its results’, pp.19-20
11. Edwin Chadwick, ‘Sanitary Progress: Address…on the Prevention of Epidemics’, Bristol Selected Pamphlets, 1882, p7-10
12. Brighton & Hove Council intercepting sewer, c 1939, Brighton & Hove Museums collection
13. Kim Price, Medical Negligence in Victorian Britain (London: Bloomsbury, 2015), p.22-23
14. Charles Keeley, ‘Living Off the Slum’, https://slumexplorers.wordpress.com/dust-and-dirt/charles-keeley/ (2015), Date accessed, 09/12/2015
15. Great Britain General Board of Health, Minutes of information collected on the practical application of sewer water and town manures to agricultural production, Earl Grey Pamphlets Collection, 1852, p.29-31